Increased coverage in WHO European Region leaves fewer children vulnerable to vaccine-preventable diseases

WHO/Malin Bring

Coverage rates for most routine vaccines in the Region increased in 2017 compared to the previous 3 years. Most notably, according to new WHO–United Nations Children’s Fund (UNICEF) estimates, 90% of children in the Region received the necessary second dose of measles-containing vaccine (MCV2) in 2017 according to their country’s routine schedule (compared to 88% in 2016), and 94% of children received the third dose of diphtheria–tetanus–pertussis-containing vaccine (DTP3) (compared to 92% in 2016).

These coverage levels, achieved through concerted efforts in many countries, represent significant progress towards reaching every child with the vaccines they deserve, when they need them most. New legislative frameworks, supplemental immunization activities, specialized training for health-care workers and immunization programme staff, strengthened procurement and logistics, tailored immunization services, and awareness-raising campaigns both during and beyond European Immunization Week are among the many initiatives countries have undertaken to address their challenges.

“Increased coverage in the Region is very welcome and a clear reflection of the commitment of our Member States to prioritize immunization,” said Dr Nedret Emiroglu, Director of the Division of Health Emergencies and Communicable Diseases at WHO/Europe.

With the 90% MCV2 coverage rate in 2017, the European Region is one of the best-performing WHO regions in vaccination against measles (second only to the Western Pacific Region). This regional achievement in 2017 is a significant step in the right direction, but it has not yet eliminated persistent pockets of vulnerability at subnational levels, where population immunity varies.

While WHO recommends immunizing at least 95% of all children with 2 doses of measles-containing vaccine in every subnational area/territory in order to achieve herd immunity, around 550 000 children born in the Region did not receive their first scheduled dose of measles-containing vaccine in 2017.

In addition, the 94% DTP3 coverage in 2017 left approximately 660 000 children unprotected against these preventable diseases. Every child who does not receive all routine vaccinations on time contributes to the pool of susceptible individuals in the Region, thereby increasing the risk of outbreaks.

“We do not have to look far to see the consequences of suboptimal immunization coverage. From January to May this year, the European Region recorded over 33 000 measles cases and, tragically, also 32 deaths,” said Dr Emiroglu. “While we have made great progress, this momentum must continue until we reach our joint vision of a Region free of vaccine-preventable diseases.”

Measles and rubella elimination

Elimination of measles and rubella is one of the regional goals set out in the European Vaccine Action Plan 2015–2020 (EVAP). The number of countries assessed by the European Regional Verification Commission for Measles and Rubella Elimination (RVC) to have interrupted endemic transmission of measles and rubella has consistently increased over the past years (to 42 and 37 respectively for 2016, with 2017 figures pending release of the RVC 2018 meeting report). However, ongoing measles outbreaks in several countries in the Region threaten this progress and the achievement of the EVAP regional goal.

WHO–UNICEF immunization coverage estimates

WHO and UNICEF jointly produce national immunization coverage estimates for 194 WHO Member States. The estimates for 2017 were released on 16 July 2018. These estimates are based on data officially reported to WHO and UNICEF by Member States, as well as data reported in published and grey literature and, wherever possible, consultation with local experts. Coverage data are reviewed and the estimates updated annually.